Your next assignment

My doctor sent my sample to the Oncotype DX folks for testing yesterday. Results should be in late next week or so. The sample undergoes testing on 21 genes. Based on the findings, I will receive a score. The lower the score, the less likely that I would benefit from chemotherapy (i.e., the less likely I will have a recurrence). If my score is low, I will likely decide to forego chemotherapy, and will begin radiation treatments.

So, here's your assignment: I need you to focus on my receiving a very low score on this test - a 10 or less. "Marcia's test will come back with a score between zero and ten." I will certainly post here as soon as I know the results. Thanks very much for your good wishes and positive thoughts! I know it makes a big difference for me, and I am so very grateful to all of you. Thank you!

Meanwhile, our local PBS station aired a program about "talking about cancer" today (March 26th). If you are interested, you may listen to the program via this link:
http://www.kpbs.org/radio/these_days

Make first decision - check!

After some re- and soul-searching, I've decided against participating in the trial. I'm just not comfortable with being randomized in the middle group. This has been a difficult decision for me. I spent years working with researchers and have a keen appreciation for their work and the courage of trial participants. I wanted to be able to say yes.

I will have the Oncotype DX test and let my score guide my decision about chemotherapy.

I'm relieved to have the most time-sensitive decision made, and plan to now have an enjoyable and relaxing weekend. I hope you do the same! Happy Easter.

Decisions to make

I met with my oncologist this morning. I've been going over the ins and outs of various treatment options in preparation for this meeting, so I had a good idea what to expect. He invited me to participate in a clinical trial, but if I do, I have to decide to do so this weekend. It's for the Oncotype DX Breast Cancer Assay. I was already very interested in the test because it evidently helps determine who will benefit most from chemotherapy. I had no idea the test would be available to me, but it is available whether I decide to participate in the trial or not. The test uses your own tissue to come up with a score which indicates the likelihood of cancer recurrence. It's a highly regarded test.

The trial involves three groups: those who score 11 or less receive hormonal treatment alone (tamoxifen, for instance); those who score between 11 and 25 are randomly assigned to receive either hormone therapy or chemo- plus hormone therapy; and those scoring 25 or more receive hormone and chemotherapy.

He was able to give me some statistical information about my cancer (from Adjuvant!.com) to help me to decide what to do. I will also be researching the Oncotype DX test further and reading whatever I can get my hands on. Wish me luck as I sort all this out.

Soy and Breast Cancer Risk

From Dr. Weil: Japanese scientists have presented new information on the effect of soy foods on breast cancer risk, at least among Japanese women: eating soy-based foods on a regular basis is protective. But excessive amounts of genistein, a compound found in soybeans, might have the opposite effect. The investigators from Japan’s National Cancer Center in Tokyo followed approximately 25,000 women between the ages of 40 and 69 for an average of ten and a half years and compared blood samples from 144 women who developed breast cancer and 288 who did not. The tests showed that women who ate whole soy foods - about 3.5 ounces of tofu daily or 1.75 ounces of natto (Japanese fermented beans) - had protective levels of genistein. This group reduced their breast cancer risk to one-third of what it was among women whose genistein levels were lowest. However, the researchers warned that excessive consumption of genistein and other isoflavone compounds from soy isolates or from supplements rather than whole soy foods may actually increase breast cancer risk.

Note from Marcia: If you take synthetic thyroid hormone supplements for hypothyroidism, check with your doctor about incorporating soy into your diet. Soy can interfere with absorption of the synthetic hormones. Generally, it is considered best to limit consumption to one serving or less of soy per day.

Do yourself a favor and follow this link...

This interview aired back in January on C-SPAN's Q&A program. It contains some very important information concerning cancer prevention from someone who should know - the volunteer president of the American Cancer Society. His story - and his mother's - are very interesting, as is his perspective on health care. It's a little long (the interview was one hour), but very much worth the read. I advise that you read the transcript rather than viewing the video because the sound quality combined with his accent may make the viewing difficult.

http://www.q-and-a.org/Program/?ProgramID=1163

"No surgery for you!"

I just came from a very happy meeting with my surgeon. He explained to me that the margins - all of them - are quite clear. One of them - the so called "deep" margin, which was on the side of the tumor closest to the chest wall, or furthest from the skin - was a very thin margin: only 1 mm. It was the most he could excise without cutting into my chest muscle which would have been a different thing altogether (essentially, a mastectomy). So he took all of the tissue he could, and that tissue was clear. He explained that there would be no point in going back and biopsying the chest muscle, since all of the margin which was removed was clear. I am satisfied on this point. And thrilled at the work he has done for me, and told him so. The tumor did measure 1.9 cm, which is 1 mm shy of the 2 cm threshold for stage 2. The cancer is positive for estrogen and progesterone receptors and negative for HER2 receptors, which are all good things. He also explained that while the cancer has not entered my lymph nodes, it is on its way there. For this reason, as well as that of the size of the tumor, my oncologist (who should be assigned shortly) will be advising me on whether or not to pursue chemotherapy in addition to radiation therapy. In any event, I will have five to six weeks of radiation as well as five years of hormone therapy. The oncologist will enter all of the specifics of my particular situation into a computer program, which will return information concerning the relative benefits of chemotherapy. If the data shows that the chemotherapy would be beneficial in my case, that's what I will do. My understanding is that the oncologist will then refer me for the chemo and/or radiation treatments. So, I'm back in waiting mode, but feeling very, very lucky indeed! The arm pain is also gradually improving (I said it was an inflamed nerve but it's actually an inflamed vein). Thanks to all of you for your kindness, caring, support, and good wishes these past few weeks. It has meant the world to me and I feel so blessed to have so many wonderful people in my life! Thank you. I will continue to update as I learn more.

The results are in!

But the doctor is out. Yes, my sugeon is off for a couple of days, so I won't get to talk to him about this until next week. But I have learned that the final pathology report (released late yesteday) shows that there were no cancer cells found in the biopsied lymph nodes! That is exceedingly good news. Also, the tumor measured 1.9 cm, which makes it a stage 1 cancer, which is better than stage 2 (which a tumor of 2 cm would have been considered). As I learn more about what this means for me, I will post here. Apparently, the margin of tissue surrounding the tumor is still a question mark. It may be that the surgeon will recommend additional surgery to remove more tissue from the area where the tumor was. I am all for this idea. The person I spoke to didn't want to guess at what my surgeon would recommend in this regard, but did say that the margin wasn't completely clear. At any rate, I hope to speak to the surgeon about all this Monday, but if not I do have an appointment with him on Tuesday so will learn and post more then. Meanwhile, I am bothered by inflammation of a nerve which was cut during the surgery which is causing pain in my right under/upper arm area, but this is normal and to be expected. Hoping that will ease up soon. Thanks for your continued support and good wishes! Be well.